Pain on the outside of the hip often gets labeled “hip bursitis.” Sometimes that label is accurate, but it does not always tell the whole story. The same area can hurt when the gluteal tendons are irritated, when a nearby bursa is involved, or when both are contributing. Providers often use the term greater trochanteric pain syndrome, or GTPS to describe this broader pattern.
For the patient, the distinction is practical. If outer hip pain is treated only as inflammation, the plan may overlook how the hip is handling walking, stairs, exercise, sleeping position, or a recent change in activity. It may also miss pain that is coming from the hip joint, the lower back, or another source. A good assessment starts with what you are feeling and what was happening when the pain began, then uses the exam to sort through the likely contributors.
At Prestige Health and Wellness, our providers start with an individualized assessment to understand your symptoms, movement, and function rather than relying only on the location of the pain.
Why outer-hip pain gets called bursitis
A bursa is a small, fluid-filled sac that helps tissues glide near a joint. Several sit near the greater trochanter, the bony point along the outside of the upper thigh. But the gluteus medius and gluteus minimus tendons attach in the same area, and research and imaging studies have found that these tendons are often involved in lateral hip pain. GTPS gives providers a way to describe the region without assuming the bursa is the only issue.
An old bursitis diagnosis may not explain a new flare. A provider still needs to ask what changed, whether the hip is painful to touch, which movements hurt, and whether symptoms in the groin, back, or leg point somewhere else.
What GTPS can feel like during the day
GTPS often feels like an ache or a tender spot over the outside of the hip. It may hurt to sleep on that side, climb stairs, get out of a low chair, run, or stand on one leg. A recent increase in walking, hills, or lower body workouts can matter. In Manhattan, even a week with more subway stairs or longer walks can be enough to expose a hip that was not ready for the added load.
The patterns of pain, the location of that pain, and what triggers it are all good notes to bring to your provider to identify the cause and plan your treatment.
What a provider may check
What you tell the provider matters as much as any single test. A provider may ask when the pain started, whether your routine changed, what aggravates or settles it, and how much it affects sleep, stairs, walking, or exercise. The exam may include pressure over the outer hip, resisted hip movements, strength testing, walking, balance on one leg, and a step-down or stair movement. The hip joint, lower back, and neurological signs may also need to be checked.
A 2024 systematic review of diagnostic tests found that tenderness over the gluteal tendon region and pain during resisted hip abduction were more useful when considered together. The authors rated the certainty of the evidence from very low to moderate. Exam findings can move the provider closer to or farther from GTPS, but one test should not make the diagnosis on its own.
Most patients do not need imaging simply because the outside of the hip hurts. Ultrasound or MRI may be useful when the diagnosis remains unclear, symptoms are not improving with an appropriate plan, a significant tendon tear or another condition is suspected, or the result would change treatment or referral. Imaging should answer a clinical question; it does not replace the history and exam.
What the research says about exercise
When the assessment supports gluteal tendinopathy or GTPS, education about tendon load and a progressive exercise plan have some of the strongest support among conservative treatment options.
One of the better-known studies is the LEAP randomized clinical trial. It included 204 adults ages 35 to 70 with lateral hip pain lasting more than three months and MRI-confirmed gluteal tendinopathy.
Participants received education plus exercise, one corticosteroid injection, or a wait-and-see approach. The education-and-exercise group had 14 physical therapy visits over eight weeks, along with guidance on managing tendon load.
At eight weeks, the education-and-exercise group reported better overall improvement and less pain than either the injection or wait-and-see groups. At 52 weeks, education plus exercise still had an advantage over injection for overall improvement, while pain intensity was similar between those two groups.
That is useful direction, but it is not a template for every sore hip. The LEAP trial studied a specific group with persistent, MRI-confirmed gluteal tendinopathy. A 2024 review of six randomized trials involving 733 participants also found small long-term improvements in pain, physical function, and patients’ overall sense of change. The authors still emphasized that the evidence came from a limited number of studies.
The practical part is finding the right starting load. A person who is sore after a short walk should not begin where a runner who only hurts on hills begins. The plan should challenge the hip without repeatedly provoking it, then build as tolerance improves.
What you can try at home
If the pain is mild, familiar, and starting to improve, a few temporary changes may help:
- Break up or scale back the activity that keeps aggravating the hip, but do not stop all movement if easy movement feels comfortable.
- Avoid lying directly on the painful side for long periods. A pillow between the knees may make side sleeping more comfortable.
- Reduce your exposure to hills, repeated stairs, long walks, or high running volume for a short period if those are increasing the pain.
- Keep gentle movement that feels tolerable instead of repeatedly testing the hip at its most painful level.
Be careful with aggressive stretching, deep pressure, or rolling directly over a tender outer hip. Stop if a technique makes the pain worse, changes where the pain moves, or causes weakness, numbness, or tingling. Rest may settle a flare, but a gradual return to load is usually needed to rebuild tolerance.
When hip pain needs medical attention
Seek urgent medical care after a fall or injury if the pain is severe, you cannot walk or put weight on the leg, or you develop tingling or loss of feeling. NHS guidance on hip pain also advises urgent evaluation for a hip that is hot or swollen, skin color changes around the hip, or hip pain with fever or feeling generally unwell.
For non-urgent outer-hip pain, an assessment is reasonable when symptoms keep interrupting sleep, change the way you walk, limit stairs or workouts, worsen quickly, or return each time you increase activity. New weakness, numbness, or pain traveling down the leg also deserves prompt attention because the hip may not be the only area involved.
How an assessment can narrow the possibilities
At Prestige Health & Wellness, the first step is to understand whether the symptoms fit hip bursitis or GTPS and whether the lower back, hip joint, or another source may be contributing.
Physical therapy may fit when the plan involves rebuilding hip strength and returning to walking, running, stairs, or workouts. If lower back symptoms or joint mobility are part of the picture, chiropractic care or a combination of modalities may be considered. Not every patient needs several services. The recommendation should follow the findings.
Deciding what to do next
You do not need to decide on your own whether the bursa or a tendon is responsible. If outer-hip pain is lingering, returning with activity, or changing how you sleep, walk, or exercise, schedule an assessment with PHW. The visit can help clarify what is contributing and what kind of plan makes sense for you.
